You can live without your pancreas, but you’ll have to take medicines to replace what it does in your body. Thanks to new medicines, life expectancy after pancreas removal surgery is rising.
Your pancreas makes substances that control your blood sugar and help your body digest foods.
Surgery to remove the whole pancreas is rarely done anymore. However, you might need this surgery if you have pancreatic cancer, severe pancreatitis, or damage to your pancreas from an injury.
our outlook will depend on the condition you have. One study found that the seven-year survival rate after surgery for people with noncancerous conditions like pancreatitis was 76 percent. But the seven-year survival rate for people with pancreatic cancer was 31 percent.
The pancreas is a gland located in your abdomen, underneath your stomach. It’s shaped like a large tadpole, with a round head and a thinner, tapered body. The “head” is curved into the duodenum, the first part of your small intestine. The “body” of the pancreas sits between your stomach and spine.
The pancreas has two kinds of cells. Each type of cell produces a different substance.
- Endocrine cellsproduce the hormones insulin, glucagon, somatostatin, and pancreatic polypeptide. Insulin helps lower blood sugar, and glucagon raises blood sugar.
- Exocrine cellsproduce enzymes that help digest food in the intestine. Trypsin and chymotrypsin break down proteins. Amylase digests carbohydrates, and lipase breaks down fats.
Diseases that might require pancreas removal surgery include:
- Chronic pancreatitis. This inflammation in the pancreas gets worse over time. Surgery is sometimes done to relieve pancreatitis pain.
- Pancreatic and other local cancers, such as adenocarcinoma, cystadenocarcinoma, neuroendocrine tumors, intraductal papillary neoplasms, duodenal cancer, and lymphoma. These tumors begin in or near the pancreas but can spread to other parts of the body. Cancer that spreads to the pancreas from other organs can also require surgery to remove the pancreas.
- Injury to the pancreas. If the damage is severe, you may need to have your pancreas removed.
- Hyperinsulinemic hypoglycemia. This condition is caused by high levels of insulin, which makes your blood sugar drop very low.
Surgery to remove your whole pancreas is called a total pancreatectomy. Because other organs sit close to your pancreas, the surgeon may also remove:
- your duodenum (the first part of your small intestine)
- your spleen
- part of your stomach
- your gallbladder
- part of your bile duct
- some lymph nodes near your pancreas
You may need to go on clear liquids and take a laxative the day before your surgery. This diet cleans out your bowels. You may also need to stop taking certain medicines a few days before surgery, especially blood thinners like aspirin and warfarin (Coumadin). You’ll be given general anesthesia to make you sleep through surgery and prevent pain.
After your pancreas and other organs are removed, your surgeon will reconnect your stomach and the rest of your bile duct to the second part of your intestine — the jejunum. This connection will allow food to move from your stomach into your small intestine.
If you have pancreatitis, you may have the option of getting an islet auto transplant during your surgery. Islet cells are the cells in your pancreas that produce insulin. In auto transplantation, the surgeon removes the islet cells from your pancreas. These cells are placed back into your body so you can keep making insulin on your own.
After surgery, you’ll be taken to a recovery room to wake up. You might need to stay in the hospital for a few days, or up to two weeks. You’ll have a tube in your abdomen to drain fluids from your surgery site. You might also have a feeding tube. Once you can eat normally, this tube will be removed. Your doctor will give you medicine to control your pain.
After surgery, you’ll have to make some changes.
Because your body will no longer produce a normal amount of insulin to control your blood sugar, you will have diabetes. You’ll need to monitor your blood sugar and take insulin at regular intervals. Your endocrinologist or primary care doctor will help you manage your blood sugar.
Your body also won’t make the enzymes needed to digest food. You’ll have to take an enzyme replacement pill each time you eat.
To stay healthy, follow a diabetic diet. You can eat a variety of foods, but you’ll want to watch carbohydrates and sugars. It’s also important to avoid low blood sugar. Try to eat small meals throughout the day to keep your sugar level steady. Carry around a source of glucose with you in case your blood sugar dips.
Also, incorporate exercise during the day. Staying active will help you regain strength and manage your blood sugar levels. Try walking a little bit each day to start, and ask your doctor when it’s safe for you to increase your exercise intensity.
You can live without your pancreas — as well as your spleen and gallbladder, if they’ve also been removed. You can also live without organs like your appendix, colon, kidney, and uterus and ovaries (if you’re a woman). However, you’ll need to make some adjustments to your lifestyle. Take the medicines your doctor prescribes, monitor your blood sugar, and stay active.